Roithmann R, Chapnik J, Zamel N, Barreto S M, Cole P
Department of Otolaryngology, Mount Sinai Hospital, University of Toronto, Canada.
Am J Rhinol. 1997 Sep-Oct;11(5):379-85. doi: 10.2500/105065897781286016.
The aims of this study are to assess nasal valve cross-sectional areas in healthy noses and in patients with nasal obstruction after rhinoplasty and to evaluate the effect of an external nasal dilator on both healthy and obstructive nasal valves. Subjects consisted of (i) volunteers with no nasal symptoms, nasal cavities unremarkable to rhinoscopy and normal nasal resistance and (ii) patients referred to our clinic complaining of postrhinoplasty nasal obstruction. All subjects were tested before and after topical decongestion of the nasal mucosa and with an external nasal dilator. In 79 untreated healthy nasal cavities the nasal valve area showed two constrictions: the proximal constriction averaged 0.78 cm2 cross-section and was situated 1.18 cm from the nostril, the distal constriction averaged 0.70 cm2 cross-section at 2.86 cm from the nostril. Mucosal decongestion increased cross-sectional area of the distal constriction significantly (p < 0.0001) but not the proximal. External dilation increased cross-sectional area of both constrictions significantly (p < 0.0001). In 26 post-rhinoplasty obstructed nasal cavities, only a single constriction was detected, averaging 0.34 cm2 cross-section at 2.55 cm from the nostril and 0.4 cm2 at 2.46 cm from the nostril, before and after mucosal decongestion respectively. External dilation increased the minimum cross-sectional area to 0.64 cm2 in these nasal cavities (p < 0.0001). We conclude that the nasal valve area in patients with postrhinoplasty nasal obstruction is significantly smaller than in healthy nasal cavities as shown by acoustic rhinometry. Acoustic rhinometry objectively determines the structural and mucovascular components of the nasal valve area and external dilation is an effective therapeutical approach in the management of nasal valve obstruction.
本研究的目的是评估健康鼻腔以及鼻整形术后鼻塞患者的鼻瓣横截面积，并评估鼻外扩张器对健康和阻塞性鼻瓣的影响。研究对象包括：（i）无鼻部症状、鼻内镜检查鼻腔无异常且鼻阻力正常的志愿者，以及（ii）因鼻整形术后鼻塞前来我院就诊的患者。所有受试者在鼻黏膜局部减充血前后以及使用鼻外扩张器后均接受了测试。在79个未经治疗的健康鼻腔中，鼻瓣面积显示出两个狭窄部位：近端狭窄部位的平均横截面积为0.78平方厘米，位于距鼻孔1.18厘米处；远端狭窄部位的平均横截面积为0.70平方厘米，位于距鼻孔2.86厘米处。黏膜减充血显著增加了远端狭窄部位的横截面积（p < 0.0001），但对近端狭窄部位无影响。外部扩张显著增加了两个狭窄部位的横截面积（p < 0.0001）。在26个鼻整形术后阻塞性鼻腔中，仅检测到一个狭窄部位，黏膜减充血前后分别平均横截面积为0.34平方厘米（距鼻孔2.55厘米处）和0.4平方厘米（距鼻孔2.46厘米处）。外部扩张使这些鼻腔的最小横截面积增加到0.64平方厘米（p < 0.0001）。我们得出结论，鼻声反射测量显示，鼻整形术后鼻塞患者的鼻瓣面积明显小于健康鼻腔。鼻声反射测量客观地确定了鼻瓣区的结构和黏膜血管成分，外部扩张是治疗鼻瓣阻塞的有效方法。
